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GM Biomechanics > Exam 2: Thoracic Spine > Flashcards

Exam 2: Thoracic Spine Flashcards

(69 cards)

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1
Q

What is the least mobile part of the spinal column designed for rigidity

A

The thoracic spine

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2
Q

What problems is the thoracic spine prone to

A

Chronic postural problems, myofascial pain syndromes

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3
Q

Biomechanical changes to t/s may result in what

A

Effects to sympathetic nervous system (T1-L2)

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4
Q

What limits extension in t/s

A

Imbrication

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5
Q

What is the the facet like for the rib articulation of the t/s

A

Concave facet on the anterior side

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6
Q

What degree is facet orientation

A

60 degrees

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7
Q

From the frontal plane toward midline what is the y axis rotation

A

20 degree

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8
Q

What is the inferior articular process orientation of the t/s

A

Ant, inf, med

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9
Q

What is the superior articular process orientation of t spine

A

Post, sup, lateral

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10
Q

Whats different about t/s ivd

A

They are comparatively thin

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11
Q

What is the disct height to body height ratio in t/s

A

1:5 smallest spinal ratio

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12
Q

What is special about the nucleus

A

Its more centrally located witihin the annulus than other

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13
Q

What is the thoracic curve

A

Kyphotic less than 55 degrees (avg 45)

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14
Q

What maintains the kyphotic thoracic curve

A

Wedge shaped vertebra (higher posteriorly)

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15
Q

Where is the apex of the thoracic curve

A

T6-T7

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16
Q

What problems can result of alteration of thoracic kiyphotic curve

A

Chronic stretch of trap, post back muscles, crowds thoracic viscera, sheurmann disease

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17
Q

What ROM is most limited in t/s

A

Extension due to impaction of articular processes and spinous

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18
Q

What is the primary movement of t/s

A

Lateral bending coupled with axial rotation

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19
Q

What is lateral bend coupled with

A

Axial rotation more apparent in upper t/s

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20
Q

What coupling pattern is seen T1-T4

A

Spinous to contralateral side during coupling

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21
Q

What coupling happens T9-T12

A

Spinous to more ipsilateral side like lumbar

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22
Q

Thoracic flexion and extension combine with what coupled movement

A

Slight +/- z translation

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23
Q

When walking where is the greatest rotation of the spine

A

Mid thoracics

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24
Q

What plays a role in enhancing stiffness of t/s especially in extension

A

The rib cage

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25
When does the rib cage increase Y axis stability
During compression
26
Without muscles and rib cage the ligamentous spine can only support how much force
20N
27
What two groups does rib articulations get divided into
Costovertebral joints, costotransverse joints
28
Which ribs articulate with a single VB
Ribs 1 and 10-12
29
What rib heads also articulate with adjacent vertebra
Ribs 2-9
30
What ribs don’t have costotransverse articulations
Ribs 11-12
31
What rib heads have costotransverse articulations
Ribs 1-10
32
What ribs connect to the sternum directly via costal cartilage
Ribs 1-7 = true ribs
33
What ribs attach indirectly via shared costal cartilage
Ribs 8-10 false ribs
34
What ribs are free floating with no anterior attachement
Ribs 11-12 = floating ribs
35
Change from the coronal facet plane in the t spine to the sagittal plane facets in the l spine typically occur where
T11-T12
36
What forms the cluneal nerves
Posterior primary rami of spinal roots T12-L2
37
What syndrome could account for up to 60% of chronic and acute back pain
Maigne syndrome
38
Curves <10% are often just ____ changes
Postural
39
If a curve is >10% accompanied by vertebral rotation it is called what?
Scoliosis
40
What side scoliosis is mc
Right thoracic
41
What scoliosis is often caused by some postural problem, muscle spasm, or leg length inequality, which can often be addressed
Functional scoliosis
42
What type of scoliosis is bony distortion, does not reduce with postural maneuves
Structural scoliosis
43
At what age does scoliosis most often develop between
Ages 10-15
44
Who is mc affected by scolioses
Girls
45
Why should kids of parents or siblings are affected by scolisosis should be evaluated
Because it can be inherited
46
What idiopathic scoliosis is mc
Adolescent idiopathic scoliosis (AIP)
47
What is the ratio of girls to boys with curves >30%
10:1
48
What girls are at the highest risk of scoliosis progression
Scoliosis greater than 25 degrees and who have not had their first period
49
What is low risk percentage of progression
5-15
50
What is moderate risk of curve progression
15-40%
51
What is high risk of curve progression
40-70%
52
What is very high risk percentage of risk of curve progression
70-90%
53
What risser grade is 25% ossified
1
54
What risser grade is 50% ossified
50%
55
What risser grade is skeletal maturity
5
56
When is bracing a treatment option
For kids who have not reaching skeletal maturity and who have curves between 25-45%
57
When is surgery a treatment option for scoliosis
When curves are >45% and progressive or when it can affect vital funx
58
What are some chiropractic interventions for scoliosis
Adjust, exercise, EMS, none should be used alone
59
According to american academy of orthopedic surgeouns when should we screen girls and boys
Girls = ages 11 and 13, boys = ages 13 or 14
60
According to american academy of pediatrics when should we screen for scoliosis
Screen at 10, 12, 14, 16
61
What test asks patients to bend forward to test assymetry
Adams forward bend test
62
What angle between intersecting lines drawn perpendicular to the top of the superior vertebra and bottom of the inferior vertebra
The cobb angle
63
What brace also includes a neck ring
Milwaukee brace
64
What are the braces at successful at
74% success rate at halting curve progression
65
How often should braces be worn
23 hours a da at least 16 hours a day
66
Curves growing in children >40 degrees require what
Spinal fusion (risser grade 0-1 in girls and 2-3 in boys)
67
What do you lose in thoracic scoliosis surgery
Loss of kyphosis
68
Over time thoracic scoliosis surgery can lead to what
Loss of lumbar lordosis = flat back syndrome
69
In later years what can happen to discs below the fusion
Discs may degenerate below the fusion

GM Biomechanics (5 decks)

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